Candidemia Clinical Trial
Official title:
A Pilot Study for the Use of Biomarkers and Early Treatment of Invasive Candidiasis in ICU Patients
Verified date | April 2019 |
Source | Universidade Federal do Rio de Janeiro |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
This is a prospective study aimed at testing a strategy of early initiation of an antifungal
agent to patients admitted to intensive care units (ICUs) at risk for invasive candidiasis.
Score system have been developed to identify groups at very high risk for the development of
candidemia/invasive candidiasis in the ICU. These scoring system have used clinical
information with or without data on Candida colonization, and have shown reasonable
correlation with candidemia/invasive candidiasis. More recently, a biomarker - detection of
1,3-beta-D-glucan in the serum - has been tested in the early diagnosis of candidiasis. The
incorporation of biomarkers such as beta-D-glucan could help clinicians to select a group at
higher risk for candidemia, and despite the fact that these tests may give false-positive
results, their negative predictive value could be of great help.
Therefore, the objectives of this study are:
1. To assess the frequency of positive biomarkers in ICU patients at high risk to develop
invasive candidiasis/candidemia;
2. To test the strategy of early discontinuation of antifungal therapy based on repeatedly
negative blood cultures and 1,3 beta-D-glucan in the serum.
Status | Completed |
Enrollment | 85 |
Est. completion date | December 2013 |
Est. primary completion date | December 2013 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: - In the ICU for >2 days AND - Systemic antibiotics on days 1-3 of ICU OR - Central venous catheter on days 1-3 of ICU - AND at least 2 of: - Total parenteral nutrition on days 1-3 of ICU - Any dialysis on days 1-3 of ICU - Major surgery in the 7 days before admission in the ICU - Pancreatitis in the 7 days before admission in the ICU - Use of corticosteroids for at least 3 days in the 7 days before admission - Use of other immunosuppressive agents in the 7 days before admission in the ICU - In addition, the patient must have at least one of the following: - Fever (axillary temperature >37.5 oC) - Hypothermia (axillary temperature <35 oC) - Hypotension - Unexplained acidosis - Unexplained elevation in C-reactive protein Exclusion Criteria: - Antifungal for >3 days - Allergy to an echinocandin |
Country | Name | City | State |
---|---|---|---|
Brazil | Federal University of Rio de Janeiro | Rio de Janeiro | RJ |
Lead Sponsor | Collaborator |
---|---|
Universidade Federal do Rio de Janeiro |
Brazil,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Evaluate the Ocurrence of Candidemia in Patients With Negative 1,3 Beta-D-glucan Who Discontinue Anidulafungin | The main interest is to evaluate the ocurrence of candidemia in patients with negative 1,3 beta-D-glucan who discontinue anidulafungin | 30 days |
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